Individual provider Active NPI

Amanda Kathleen Meivogel

  • Acute Care Nurse Practitioner
  • Willoughby, OH
National Provider Identifier
1235386970
Registry record updated Feb 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
0041606 Issued in OH
Practice address
4128 Kirtland Rd
Willoughby, OH 44094-7924
Phone
(440) 463-6094
NPI assigned
Aug 25, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 0041606 OH Primary
Registered Nurse 163W00000X 393452 OH

Addresses

Primary practice location

4128 Kirtland Rd
Willoughby, OH 44094-7924

Mailing address

4128 Kirtland Rd
Willoughby, OH 44094-7924
Phone (440) 463-6094

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260609004292 OH Practitioner - Nurse Practitioner 1153892252 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2026
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4055 Valley View LN
Suite 700
Dallas, TX 75244-4910

4055 Valley View LN
Suite 700
Dallas, TX 75244-5045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
393452OHMDRegistered Nurse
0041606OHMDAcute Care Nurse Practitioner

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1219622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772236800000",
    "number": "1235386970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4128 KIRTLAND RD",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440947924",
            "telephone_number": "440-463-6094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4128 KIRTLAND RD",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440947924",
            "telephone_number": "440-463-6094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEIVOGEL",
        "first_name": "AMANDA",
        "middle_name": "KATHLEEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-25",
        "last_updated": "2026-02-28",
        "certification_date": "2026-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "0041606",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "393452",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willoughby, OH

Sources for this page

Verify at the official NPI Registry.